DNP Role Development for Doctoral Advanced Nursing Practice, Second Edition

210 ■ II: ROLES FOR DOCTORAL ADVANCED NURSING PRACTICE

safety practices developed within organizations are increasingly based on national stan-
dards related to accuracy in patient identification, communication systems among care
givers, and precautions for high alert medications and procedures. The AHRQ’s (2014b)
Patient Safety Network provides support and guidance to practitioners in the latest evi-
dence- based care as well as warns of hazards that pose risk to patients. AHRQ (2014c)
has also developed a valid and reliable patient safety culture survey, the Hospital Survey
on Patient Safety Culture , to help hospitals, nursing homes, primary care, and specialty
practices and clinics evaluate how well they have established a culture of safety in their
organizations. The AHRQ’s (2014c) User Comparative Database Report consists of data
from 653 hospitals in the United States that can used to compare patient safety cultures
between organizations. Table 8.6 describes the 12 Patient Safety Composites that are
measured and with their descriptions. These 12 composites can be viewed as the orga-
nizational supports needed to provide a culture supportive of patient safety practices
(AHRQ, 2014c).
AHRQ has led the way in providing the means for hospitals and other health care
organizations to focus on their health care safety practices. Examples of composite data
that demonstrate areas of strength in the AHRQ report include:

1. Teamwork Within Units (81% positive response) — the extent to which staff

support each other, treat each other with respect, and work together

as a team.

2. Supervisor/ Manager Expectations and Actions Promoting Patient Safety (76%

positive response) — the extent to which supervisors/ managers consider staff

suggestions for improving patient safety, praise staff for following the patient

safety procedures, and do not overlook the patient safety problems.

3. Organizational Learning— Continuous Improvement (73% positive response) — the

extent to which mistakes have led to positive changes and changes are evalu-

ated for effectiveness.

TABLE 8.5 Types of Program Evaluation

Program Type/ Purpose Components Measurement

Process/ Implementation

Evaluation:

Evaluates the extent to

which the program has been

implemented as intended

Target population

Regulatory requirements

Professional standards

Customer expectation

Number of participants

SES of participants

Performance Measures

Customer Feedback

Effectiveness/ Outcome

Evaluation :

Evaluates progress toward

achieving desired outcomes

Change in participant’s health

Change in participant’s risk

or protective behaviors

Change in participant’s/

population’s morbidity and

mortality

Clinical indicators (e.g., BP)

Tobacco use status

Incidence and prevalence

data of disease

Cost– Benefit Analyses:

Comparison of single

program outputs/ outcomes

with the costs (resources) to

produce them

Performance indicator related

to goal achievement

Program cost in dollars

Inpatient postoperative

infection rate

Cost of nursing and medical

staff infection control training

BP, blood pressure; SES, socioeconomic status.